Assisted living (AL) facilities have developed rapidly as a viable living option for older adults needing supportive care. With AL residents'acuity and impairments increasing, questions of quality of care in AL are emerging which parallel questions of nursing home (NH) care. The key role of physicians in providing medical care in AL has not been studied. Physicians'care in AL is heterogeneous, dictated by numerous factors and not always with regard to patient need. Ideally, physicians could play an instrumental role in maintaining an AL resident's health, function, and independence, with the AL facility supporting that physician care through collaboration or partnership efforts. For example, some facilities provide a wide array of supportive health services, all of which could be incorporated into physician care plans when AL staff and the physicians of AL residents communicate and coordinate care. In contrast, the lack of physician awareness of AL services represents a critical missed opportunity as does the unavailability of support services in an AL facility. Currently, no systematic information regarding physician care in AL facilities is available. Obtaining this information is the first step to improving the quality of medical care for millions of our elderly. Thus, guided by a conceptual framework the specific aims of the proposed project are to: Aim 1) To describe the structure and processes of medical care that 240 physicians and 120 assisted living (AL) healthcare supervisors'report providing to 480 AL residents. Aim 2) To examine how physician &practice characteristics are associated with physician care processes and with the physician-AL facility partnership processes. Aim 3) To examine how AL facility health services characteristics are associated with AL facility care processes and physician-AL facility partnership processes. Aim 4) To examine how physician care processes and AL facility care processes are associated with the physician-AL facility partnership processes. The project will use telephone interviews with physicians and AL healthcare supervisors for data collection. In terms of public health, findings will have great promise to clarify the current role and future promise of the delivery physician services in AL and associated public policy development.